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~� <br />APPLICATION FOR SANITATION PERMIT Permit No. <br />(Complete in <br />' ' mm6 <br />This Permit Expires I Year From Date Issued Dof*|*o <br />Application is hereby made to the San Joaquin Loca'l Health Distr-ict for a Permit +0 construct and install the wort herein described. <br />This application, is made in compliance �th County Ordinance No. 54'9. <br />t=~---'��' <br />.108 ADDRESS AND LOCAT <br />installation will serve: Residence M Apartment House Commercial Tra;ler Court [I Motel 0 Other <br />Number of living units: Number of bedrooms......... Number of baths ... Lot s;ze .1a <br />Wafer Supply: Public system [-I Community system R Private X Depth to Water Table -IA7P. ft. <br />Character of soil to a depth of 3 feet Sand [] Gravel [] Sandy Loom [] Clay Loam �IClay [] Adobe Hardpan n <br />Previous Application Made: Yes [], ' No [] New Construction: Yes L-] No [l FHA/VA.- Yes [] No [I <br />TYPE OF INSTALLATION AND 59BC}FlCAT|ONS/ <br />UWw septic +mnb or cesspool 'mrmiftmcl if public sewer is available within 200 feet.) <br />5op+ir Tank: Distance fmm ni*unast Well_ __-_Dis/umce from fou*6otiov----- .__-����nieL--_-----_'_........... <br />-' <br />[] No ofcmn`pa,*�nmnb_........ ........ -_Size_ ....... __-._..'Lqui66ep!h.------ _'-... Capacity_ -_---_- �� <br />�� | Field: ���ncaf�m � ~mxf ��Lv .-.Di�ance�um �uv6*�u^-.�.��-- Dis�m to lot <br />Nimber of lines'..), Length of each line__i4. 9 --.,..Width of trench._3Seepage Pit: Distance io nearest well ............. , ....Distance from foundation .................. ..Distance to nearest lot line .............Privy: Dis�ance from nearest well .... . ...... Dl's4ance frorn nearest ..........I hereby certify th + I have pr4ared this application and +he+ +he work will be done in accordance with San Joaquin Countyordinances. State laws, and ruies and regulaficins of Ae San Joaquin Local Health District,(Plot plan, showTmg size of lot, location of sysi*m in relation +0 Welk, 6u;Id;n9s. e+c.. can 6o placeJ on reverse sicle).FOP, DEPARTMENT USE ONLY <br />APPLICATION ACCEPTED Br '-_-'-_---_-___-___..D�TE~����-��/'����-__----__� <br />RBHEvVEQ BY_ ...... ...... .--....................... .................... BUILDING PERMIT BSUB1....... -............ .......... -............ <br />—__�_-------'-~~_'O/�E------_____~-_~~.�_~_--_ <br />Alterations and/or rw+wmmewd*tions:,.......... ...... _............. ............... _'...... __.-___._........ _........ ......... <br />._^_.~__^____ <br />'-_-.......................... _-_............. ............. ----~-__-_~-_....... ............... ............ ........ -_'__-----___--~~--...... <br />' <br />. _--^-...... ........... ----_---���.�'............ -- ..'-....... <br />-. ---. <br />......................... '��...... <br />316 <br />FINAL INSPECTION -----_--.� D^�-^��� . <br />SAN JOAQU|NLOCAL HEALTH DISTRICT <br />/10 Sou4, Amoricanstreet 300 West Oakw+r*a* /32 Sycamoresfrae# mwNor+h "C"s4root <br />St" ki=. czx*rnw Lod;. California Manteca, California Tracy, "H4omia <br />